| Doctor Name: | LAURA A PHEN |
| NPI Number: | 1184786675 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ED.S. |
| License Number: | LPC-MH2170 |
| Business Practice Address: | 180 10th St Se Suite 201 Le Mars, IA - 510312559 |
| Business Phone Number: | 7125464624 |
| Business Fax Number: | 7125469395 |
| Mailing Address: | 180 10th St Se, Suite 201 Po Box 70 LE MARS |
| State: | IA |
| Postal Code: | 510312559 |
| Phone Number: | 7125464624 |
| Fax Number: | 7125469395 |
| NPI Enumeration Date: | 12/14/2006 |
| NPI Last Update Date: | 11/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPC-MH2170 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |